QOLVAD Detects Changes in Emotional, Social, Cognitive and Physical Wellbeing after Continuous-Flow LVAD Implant

Abstract

Purpose Most studies report little change in quality-of-life (QOL) during continuous flow left ventricular assist device (CFLVAD) support. The aim herein is to compare a new disease-specific questionnaire (QOLVAD) vs. existing metrics of QOL at various times during CFLVAD. Methods We conducted a multicenter descriptive survey of QOL in operative survivors of CFLVAD support using the following measures: KCCQ (subjective health status); PHQ9 (depressive symptoms); 4-item PROMIS (anxiety); and QOLVAD (quality-of-life). The QOLVAD is a questionnaire with Likert-type responses for physical, emotional, social, cognitive, and spiritual domains. Standardized QOLVAD scores range from 0-100 (higher=better QOL). Patients were grouped by quintiles according to time postop. that scores were obtained. Scores were compared using linear regression, adjusting for age. Results The sample of 146 was obtained from the overall cohort which was 82% male, 77% white, 50% BTT, with mean age of 58.5±13.8 years. Surveys were completed at mean 82±97 weeks postop with testing time frame quintiles as below (Table). While there were no significant differences in overall QOLVAD scores based on time postop testing occurred, there were time-dependent differences in components of the scores (Table). Physical wellbeing was lower in those tested after shorter durations of support, possibly reflecting operative debilitation. Patients tested after longer periods of support had lower emotional, social and cognitive wellbeing compared with earlier implants. Depression, anxiety, and KCCQ metrics did not change over time. Conclusion These results suggest that the QOLVAD is sensitive to time-dependent changes in patient measures of physical, emotional, social, and cognitive wellbeing after CFLVAD. In contrast, the KCCQ, PHQ9 and Promis failed to show similar changes over time. These results support need for prospective, longitudinal analyses to detect within-patient differences of QOLVAD measures.